Madilyn wasn't keeping up with her sister, had some speech problems and showed repetitive behaviors, such as rubbing things on her face and sniffing things.

"And she didn't play with other kids. She played alone," Wendy said.

The diagnosis of autism, or autistic spectrum disorder, has exploded in recent years. Janine Stichter, Ph.D., is the director of graduate studies and associate professor in the University of Missouri-Columbia special education. She is often used as a resource by the Midland County Educational Service Agency, the county's intermediate school district that provides specialized services to children with disabilities.

In a recent e-mail interview, Stichter said previously autism was narrowly defined and only a small group of children were diagnosed with it. The Diagnostic and Statistical Manual-IV, used by doctors to make psychiatric diagnoses, has changed that. The DSM-IV includes Rett syndrome, child disintegrative disorder, autism, Asperger syndrome and other disorders under "autistic spectrum disorder." Symptoms include social, behavior and communication problems.

Madilyn is considered a high functioning autistic. Stichter said more children are diagnosed with the severe form of autism, in part because of recent research.

"There are two potential groups, those with complex autism and those with essential autism," Stichter wrote.

People with complex autism have obvious impairments or impacts, and these impairments are affected by such things as environmental birth or genetics. People with essential autism do not seem to have any other things affecting them other than the autism.

Madilyn struggles with speech, but otherwise is a fairly easygoing child. Wendy said she is affectionate and has a "big sense of humor."

"And she's a lot more interested in playing with other kids," Wendy said.

Madilyn goes to the MCESA pri-primary classroom every day. Wendy credits the ESA and its staff for Madilyn's progress.

There are many ways to educate children with autism, ranging from direct instruction to increasing structure and routines. Stichter said some children with autism also are helped by dealing with sensory stimulation problems, such as dislike of touch or noise.

But Stichter stressed communication skills are key. Both limitation and frustration can be linked to the lack of ability to communicate.

The prognosis for autistic children is all over the map. Early and effective intervention can mean success. Community integration and post-school experiences are very important.

She said there are many genius level students with autism who stay at home doing nothing after high school, in part because their social and community skills were not made a priority.

"So they can't handle university life or they get fired from numerous jobs due to their challenging interpersonal skills," Stichter said.

There are other people with autism and moderate mental retardation who hold down a job and have an active personal life.

"In other words, research is not at a point yet where we can cure them, but we can certainly have a significant impact," Stichter said.